Prediagnosis- Electrodiagnosis; How Much Concordant?

Aim:Electrodiagnostic test is a study that gives information about underlying neuromuscular disorder, so practically it is accepted as an extension of physical examination. It aids in the diagnosis and treatment of the disorder, if it is done in appropriate protocole. The more right indication of the claims are, the higher the concordance and the better the clinical benefit. In this study we aim to evaluate concordance ratio of electrodiagnosis with prediagnosis in our Electroneuromyography (ENMG) Unit.Materials and Methods:According to concardance between prediagnosis and electrodiagnosis results, the electrodiagnostic requests and ouput in the Electroneuromyography (ENMG) Unit of Namık Kemal University Mecidine Faculty, Department of Physical Medicine and Rehabilitation were evaluated retrospectively, between February 2016- February 2018.Results:By evaluating prediagnosis and electrodiagnosis, 200 of totally 204 electrodiagnostic study were included in the study. 55 of the requests were male and 145 were female, they were respectively 48,89± 13,41 and 47,62± 13,06 years old. Electrodiagnostic results were: 53 normal, 142 entrapment neuropathy, 28 radiculopathy/plexopathy, 28 polineuropathy, 2 myopathy. In our clinic 26,5% of the electrodiagnostic studies were normal. 73,5% of anormal electrodiagnostic study composed of 61,5% of prediagnosis concordant electrodiagnostic result and 12% of different diagnosis from prediagnosis.Conclusion:The concordance between prediagnosis and elecrodiagnostic results of electrodiagnostic studies depends on the requests with well defined indications. After anamnesis, physical and neurological examination, the electrodiagnostic test with proper requests and practice is a valuable study in planning the treatment or follow-up of the progression. Request without any indication will decrease the value of electrodiagnostic test and results in elongation of waiting time, unnecessary patient intensity, lost of time and sources

İzmir‐Ankara suture as a Triassic to Cretaceous plate boundary – data from central Anatolia

The İzmir‐Ankara suture represents part of the boundary between Laurasia and Gondwana along which a wide Tethyan ocean was subducted. In northwest Turkey, it is associated with distinct oceanic subduction‐accretion complexes of Late Triassic, Jurassic and Late Cretaceous ages. The Late Triassic and Jurassic accretion complexes consist predominantly of basalt with lesser amounts of shale, limestone, chert, Permian (274 Ma zircon U‐Pb age) metagabbro and serpentinite, which have undergone greenschist facies metamorphism. Ar‐Ar muscovite ages from the phyllites range from 210 Ma down to 145 Ma with a broad southward younging. The Late Cretaceous subduction‐accretion complex, the ophiolitic mélange, consists of basalt, radiolarian chert, shale and minor amounts of recrystallized limestone, serpentinite and greywacke, showing various degrees of blueschist facies metamorphism and penetrative deformation. Ar‐Ar phengite ages from two blueschist metabasites are ca. 80 Ma (Campanian). The ophiolitic mélange includes large Jurassic peridotite‐gabbro bodies with plagiogranites with ca. 180 Ma U‐Pb zircon ages. Geochronological and geological data show that Permian to Cretaceous oceanic lithosphere was subducted north under the Pontides from the Late Triassic to the Late Cretaceous. This period was characterized generally by subduction‐accretion, except in the Early Cretaceous, when subduction‐erosion took place. In the Sakarya segment all the subduction accretion complexes, as well as the adjacent continental sequences, are unconformably overlain by Lower Eocene red beds. This, along with the stratigraphy of the Sakarya Zone indicate that the hard collision between the Sakarya Zone and the Anatolide‐Tauride Block took place in Paleocene

Prediagnosis- Electrodiagnosis; How Much Concordant

Elektrodiyagnostik çalı?ma pratikte klinik muayenin devamı olarak görülen, altta yatan nöromuskuler bozukluk hakkında bilgi veren bir çalı?madır. Uygun protokollerde yapıldığında hastalığın tanı ve tedavisinde yardımcı olmaktadır. ?stemler ne kadar doğru endikasyonda istenirse, o kadar yüksek oranda tutarlı sonuç elde edilir ve klinik fayda artar. Bu çalı?mada Elektronöromiyografi (ENMG) ünitemizde elde edilen Elektrodiyagnostik tanı (EDT)’ların ön tanılar ile ne kadar uyumlu olduğunu saptamayı amaçladık.Elektrodiyagnostik çalı?ma pratikte klinik muayenin devamı olarak görülen, altta yatan nöromuskuler bozukluk hakkında bilgi veren bir çalı?madır. Uygun protokollerde yapıldığında hastalığın tanı ve tedavisinde yardımcı olmaktadır. ?stemler ne kadar doğru endikasyonda istenirse, o kadar yüksek oranda tutarlı sonuç elde edilir ve klinik fayda artar. Bu çalı?mada Elektronöromiyografi (ENMG) ünitemizde elde edilen Elektrodiyagnostik tanı (EDT)’ların ön tanılar ile ne kadar uyumlu olduğunu saptamayı amaçladık

Milwaukee shoulder-knee syndrome: A case report [Milwaukee omuz-diz sendromu: Bir olgu sunumu]

Basic calcium phospate crystals frequently may form asymptomatic deposits that may give rise to several clinical syndromes, including calsific periarthritis, tendinitis, bursitis, Milwaukee shoulder syndrome, osteoarthritis, calcific tendinitis and bursitis, and mixed crystal deposition in and around joints. Milwaukee shoulder syndrome is a well defined clinical entity that can be observed particular in older women. It is a destructive arthropathy associated with the deposition of cristals, rotator cuff tear, and joint instability. Clinical features include pain, swelling and progressive functional impairment

Subduction, ophiolite genesis and collision history of Tethys adjacent to the Eurasian continental margin: New evidence from the Eastern Pontides, Turkey

This paper presents several types of new information including U-Pb radiometric dating of ophiolitic rocks and an intrusive granite, micropalaeontological dating of siliceous and calcareous sedimentary rocks, together with sedimentological, petrographic and structural data. The new information is synthesised with existing results from the study area and adjacent regions (Central Pontides and Lesser Caucasus) to produce a new tectonic model for the Mesozoic-Cenozoic tectonic development of this key Tethyan suture zone.The Tethyan suture zone in NE Turkey (Ankara-Erzincan-Kars suture zone) exemplifies stages in the subduction, suturing and post-collisional deformation of a Mesozoic ocean basin that existed between the Eurasian (Pontide) and Gondwanan (Tauride) continents. Ophiolitic rocks, both as intact and as dismembered sequences, together with an intrusive granite (tonalite), formed during the Early Jurassic in a supra-subduction zone (SSZ) setting within the İzmir-Ankara-Erzincan ocean. Basalts also occur as blocks and dismembered thrust sheets within Cretaceous accretionary melange. During the Early Jurassic, these basalts erupted in both a SSZ-type setting and in an intra-plate (seamount-type) setting. The volcanic-sedimentary melange accreted in an open-ocean setting in response to Cretaceous northward subduction beneath a backstop made up of Early Jurassic forearc ophiolitic crust. The Early Jurassic SSZ basalts in the melange were later detached from the overriding Early Jurassic ophiolitic crust.Sedimentary melange (debris-flow deposits) locally includes ophiolitic extrusive rocks of boninitic composition that were metamorphosed under high-pressure low-temperature conditions. Slices of mainly Cretaceous clastic sedimentary rocks within the suture zone are interpreted as a deformed forearc basin that bordered the Eurasian active margin. The basin received a copious supply of sediments derived from Late Cretaceous arc volcanism together with input of ophiolitic detritus from accreted oceanic crust.Accretionary melange was emplaced southwards onto the leading edge of the Tauride continent (Munzur Massif) during latest Cretaceous time. Accretionary melange was also emplaced northwards over the collapsed southern edge of the Eurasian continental margin (continental backstop) during the latest Cretaceous. Sedimentation persisted into the Early Eocene in more northerly areas of the Eurasian margin.Collision of the Tauride and Eurasian continents took place progressively during latest Late Palaeocene-Early Eocene. The Jurassic SSZ ophiolites and the Cretaceous accretionary melange finally docked with the Eurasian margin. Coarse clastic sediments were shed from the uplifted Eurasian margin and infilled a narrow peripheral basin. Gravity flows accumulated in thrust-top piggyback basins above accretionary melange and dismembered ophiolites and also in a post-collisional peripheral basin above Eurasian crust. Thickening of the accretionary wedge triggered large-scale out-of-sequence thrusting and re-thrusting of continental margin and ophiolitic units. Collision culminated in detachment and northward thrusting on a regional scale.Collisional deformation of the suture zone ended prior to the Mid-Eocene (~45 Ma) when the Eurasian margin was transgressed by non-marine and/or shallow-marine sediments. The foreland became volcanically active and subsided strongly during Mid-Eocene, possibly related to post-collisional slab rollback and/or delamination. The present structure and morphology of the suture zone was strongly influenced by several phases of mostly S-directed suture zone tightening (Late Eocene; pre-Pliocene), possible slab break-off and right-lateral strike-slip along the North Anatolian Transform Fault.In the wider regional context, a double subduction zone model is preferred, in which northward subduction was active during the Jurassic and Cretaceous, both within the Tethyan ocean and bordering the Eurasian continental margin. © 2014 Taylor & Francis.Natural Environment Research Council: IMF01000

Collision Chronology Along the İzmir‐Ankara‐Erzincan Suture Zone: Insights From the Sarıcakaya Basin, Western Anatolia

International audienceDebate persists concerning the timing and geodynamics of intercontinental collision, style of syncollisional deformation, and development of topography and fold-and-thrust belts along the >1,700-km-long İzmir-Ankara-Erzincan suture zone (İAESZ) in Turkey. Resolving this debate is a necessary precursor to evaluating the integrity of convergent margin models and kinematic, topographic, and biogeographic reconstructions of the Mediterranean domain. Geodynamic models argue either for a synchronous or diachronous collision during either the Late Cretaceous and/or Eocene, followed by Eocene slab breakoff and postcollisional magmatism. We investigate the collision chronology in western Anatolia as recorded in the sedimentary archives of the 90-km-long Sarıcakaya Basin perched at shallow structural levels along the İAESZ. Based on new zircon U-Pb geochronology and depositional environment and sedimentary provenance results, we demonstrate that the Sarıcakaya Basin is an Eocene sedimentary basin with sediment sourced from both the İAESZ and Söğüt Thrust fault to the south and north, respectively, and formed primarily by flexural loading from north-south shortening along the syncollisional Söğüt Thrust. Our results refine the timing of collision between the Anatolides and Pontide terranes in western Anatolia to Maastrichtian-Middle Paleocene and Early Eocene crustal shortening and basin formation. Furthermore, we demonstrate contemporaneous collision, deformation, and magmatism across the İAESZ, supporting synchronous collision models. We show that regional postcollisional magmatism can be explained by renewed underthrusting instead of slab breakoff. This new İAESZ chronology provides additional constraints for kinematic, geodynamic, and biogeographic reconstructions of the Mediterranean domain

Permo-Carboniferous granitoids with Jurassic high temperature metamorphism in Central Pontides, Northern Turkey

In the northern part of the Central Pontides (N Turkey) there are different metamorphic rocks exposed, notably the Devrekani metamorphic rocks. Here, upper amphibolite-lower granulite facies metamorphic rocks contain predominantly paragneiss, orthogneiss and metacarbonate, and to a lesser extent, amphibolite and quartzite, with cross-cutting aplite, pegmatite and granite veins. This is the first report of these rocks and includes new data on the petrochemistry, geochronology and metamorphic evolution of the Devrekani orthogneisses from the Central Pontides. The orthogneisses show five different mineral parageneses with the characteristic mineral assemblage quartz + K-feldspar + plagioclase + biotite ± hornblende ± opaque (± ilmenite and ± magnetite), and accessory minerals (zircon, sphene and apatite). These metamorphic rocks exhibit generally granoblastic, lepidogranoblastic and nematolepidogranoblastic with locally migmatitic and relic micrographic textures. They have well-developed centimeter-spaced gneissic banding and display gneissose structure with symmetric, asymmetric and irregular folds. The petrographic features, mineralogical assemblages and weak migmatization reflect high temperature conditions. Thermometric calculations in the orthogneisses indicate metamorphic temperatures reached 744 ± 33 °C. Field relations, petrography and petrochemistry suggest that the orthogneisses have predominantly granodioritic and some granitic protoliths, that show features of I-type, medium to high-potassic calc-alkaline volcanic arc granitoids. The orthogneisses have high contents of LILEs and low contents of HFSEs with negative Nb and Ti anomalies, which are typical of subduction-related magmas. The orthogneisses also show significant LREE enrichment relative to HREE with negative Eu anomalies (EuN/Eu* = 0.33–1.07) with LaN/LuN = 6.98–20.47 values. Based on U-Pb zircon dating data, the protoliths are related to Permo-Carboniferous (316–252 Ma) magmatism. It is likely that peak metamorphism took place during the Jurassic as reflected by the U-Pb zircon ages (199–158 Ma) and also 40Ar/39Ar from hornblende/biotite (163–152 Ma). The four biotite 40Ar/39Ar average ages from the rock samples are ca. 156 Ma, suggesting that the metamorphic rocks cooled to 350–400 °C at ca. 156 Ma. Conclusively, the Devrekani metamorphic rocks can be ascribed as products of Permo-Carboniferous continental arc magmatism overprinted by Jurassic metamorphism in the northern Central Pontides